Provider Demographics
NPI:1285671487
Name:RAFI, AHMAD NADEEM (MD)
Entity Type:Individual
Prefix:DR
First Name:AHMAD
Middle Name:NADEEM
Last Name:RAFI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:32 COURTS DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-9021
Mailing Address - Country:US
Mailing Address - Phone:501-821-1117
Mailing Address - Fax:501-450-7921
Practice Address - Street 1:1660 W C PL
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72801-2705
Practice Address - Country:US
Practice Address - Phone:479-967-7770
Practice Address - Fax:479-967-7772
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-4802207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR162931001Medicaid
AR162931001Medicaid